Mt Holly Ski Patrol Application
Basic Info
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
*
-
Month
-
Day
Year
Date
Now
-
Month
-
Day
Year
Date
Age
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Minor
Minors are encouraged to join. We welcome anyone over the age of 16 years of age on March 1st, 2023 to apply. Please supply the following Information. The Patrol director will contact your parent to explain commitment, answer all questions and obtain consent.
Parent / Guardian Name
First Name
Last Name
Parent / Guardian Email
example@example.com
Parent / Guardian Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Experience
Emergency care experience (None required)
None
OEC Tech
EMT
Paramedic
Nurse (LPN, RN)
Doctor (MD, DO)
Other
Slope Experience
Rows
Years of Experience
Ability
Ski
None
Beginner
Intermediate
Advanced
Snowboard
None
Beginner
Intermediate
Advanced
I plan to primarily patrol on
Skis
Snowboard
Telemark
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Past Patrol History / Transfers / Secondary
Have you patrolled in the past
Yes
No
Would you like Mt Holly to be your Primary or Secondary patrol?
Primary
Secondary
Past resorts
Years of patrolling
Have you kept up with the last 3 refreshers?
Yes
No
Region number
Ski patrol level
Patroller
Alpine Patroller
Senior Patroller
Certified Patroller
Please provide a letter of recommendation from your prior Patrol Director
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of
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Additional Info
Anything else you would like to tell us about yourself?
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Authorization
I understand that completing this application for the Mt Holly Ski Patrol in no way guarantees acceptance. I understand that my name will be added to the pool of applicants available for the patrol director and selection committee to select from. I also understand that my skiing skills and physical ability will be evaluated to discern my level of ability as it relates to performing Ski Patroller duties to the standards of the National Ski Patrol, and Mt Holly Ski Patrol. I will also submit to a standard background check.
If I am transferring from another patrol I must demonstrate competence at the level of which I am registered. If accepted as a candidate or any other level, my status as an Mt Holly Ski Patroller can be terminated at any time for any reason.
Authorization
I Accept
I Decline
Submit
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